Role of the doppler echocardiography in assessment of fluid status in chronic haemodialysis patients

The aim of this study is to examine the role of the Doppler echocardiographic parameters in the assessment of fluid status in these patients with chronic haemodialysis. Sixty subjects were included in this study. Group I Included 20 patients who had been on chronic haemodialysis 6 months at least and were normotensive without receiving anti-hypertensive agents.Group II: included 20 patients on chronic haemodialysis 6 months at least and remained hypertensive under anti-hypertensive agents. Group III: Included 20 subjects who are apparently normal without history of cardiac disease [con trol group]. The S/D [peak pulmonary vein systolic velocity [s] divided by peak pulmonary vein diastolic vlocity [D]] was significantly higher in group I [mean +/- SD = 1.886 +/- 0.214]. Then in group II [mean +/- SD = 1.123 +/- 0.169] with p-value <0.001. S/D ratio can be used as a good tool to assess the fluid status in chronic haemodialysis patients specially if combined with others as inferior vena cava diameter

Treatment of congeintal pseudarthrosis of the tibia using Iilizarov external fixator

Congenital pseudarthrosis of the tibia [CPT] is a difficult orthopaedic problem. In this study, eight cases [5 males and 3 females] with CPT were treated with Ilizarov technique. Their average age at surgery was 4.7 years [ranged from 2.5 to 15 years]. Leg length discrepancies existed in all patients ranged from 1.5 to 6.5 cm [average 3.2 cm]. All cases were followed up from 1.2 to 4 years [average 2.3 years]. Solid union was achieved with initial treatment in 6 cases [75%].Tibial lengthening ranged from 1.5 to 6 cm [average 3.6 cm]. Angular deformity was fully corrected in 7 cases [87.5%]. A total of 9 complications were encountered in 5 cases [62.5%]. All these complications were manageable. Six patients [75%] were satisfied with the results. In general, the Ilizarov technique addresses several problems associated with CPT with promising results

Treatment of unstable femoral shaft fractures with locked intramedullary nailing

Twenty two unstable femoral shaft fractures were treated by Russel Taylor interlocking nail. 63.6% were male and 36.4% were females. Their average age was 36.8 years [ +/- SD 10.33]. The lower 1/3 rd of the femur was fractured in 40.9%, the upper in 31.8% and the middle 1/3 rd in 27.3% of the cases. The fracture was comminuted in 50%, transverse in 22.8%, spiral in 13.6% and double level in 13.6. The fractures were closed in 81.9% and grade 1 open in 18.1% of the cases. Closed technique was used in 36.4% and open in 13.6%. All patients were followed up for an average of 14 months. After one year follow up 90.9% of the fractures had solid complete consolidation and 9.1% had non-union. Full weight bearing was permitted after a period ranged from 2 to 10 months [average 6.5] and occurred in 90.9% of patients. Infection occurred in 4.5% of cases and subsided with antibiotic treatment, shortening in 13.6%, non-union in 9.1%, foot drop in 4.5% and the distal screw was broken in 9.1%. The results were satisfactory [excellent and good] in 81.8% and unsatisfactory in 18.2%. Based on this study, treatment of unstable femoral shaft fracture with interlocking nail has many advantages. The risk of infection and non-union is low, incidence and severity of malunion are reduced, the hospital stay is short and early mobilization of the patient is possible

Gradual femoral lengthening using Wagner technique

Eight patients with leg length inequality underwent femoral lengthening using the Wagner technique. Their ages ranged from 15 to 20 years with an average of 17.5 +/- 2.07. Limb length inequality was due poliomyelitis in 75% of cases and femoral shaft fractures in 25% of cases. Femoral length discrepancy varied from 4.5 to 8 cm. with an average of 5.9 cm. The femoral length gained after the operation varied from 4.5 to 7 cm. with an average of 5.8 cm. Full correction was obtained in 3 cases. Three cases had remaining discrepancy from 1 to 2.5 cm. Complications included post-operative wound infection in 12.5% pin tract infection in 25%, partial peroneal nerve palsy in 12.5% and severe angulations in 12.5%. This study revealed that Wagner method of gradual bone lengtherning allows distraction while holding the bony components rigidly fixed. This allows continued hip and knee motion while protecting the neurovascular structure from rapid stretching

Cholesterol decomposing microorganisms isolated from some human skin microflora

An agarized medium with a uniform distribution of cholesterol was prepared and the ability of some human skin microflora to grow on it was tested. One of them was considered as the most potent according to its ability to decompose cholesterol as the sole source of carbon, and hence was chosen for further study. It was identified as Aspergillus fumigatus, 69. The influence of temperature, incubation period, shaking and phosphate concentration on cholesterol decomposition were investigated. Optimum temperature and pH for cholesterol decomposition were 37C and 6.6 after 12 days at 120 rpm in a medium containing 0.2 M phosphate buffer and 0.15% [w/v] cholesterol

Nutritional analysis of food consumed by patients in two of the medical wards in Tanta university general hospital

This work aimed to study the discrepancies between diet offered by hospital and diet required by patients according to their disease status; to study the discrepancies between diet consumed by patients from [hospital and home] and diet required by these patients and to measure patient acceptability of the food offered by the hospital. All 80 patients admitted to two medical wards [16 beds] in T.U.G.H. in the period of two months were examined and interviewed to obtain the main diagnosis and the actual food items consumed by patients including what was offered by hospital and food brought to patients from their homes and relatives. Each patient was interviewed to know their opinions regarding hospital food and reasons of hospital food refusal. Results revealed that hospital offered diets were different from modified required diets for all groups of patients. Also average amounts of food items consumed by patients [from hospital and home] were significantly different from what was required for each group according to their disease status which were considered harmful to patients. As regards patients opinions concerning hospital food, the study illustrated that most patients were not contented with quantity and quality of meals they recieved and the manner in which they were served